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Amyloidosis is a rare infiltrative condition resulting from the extracellular accumulation of amyloid fibrils at the cardiac level. It can be an acquired condition or due to genetic mutations. With the progression of imaging technologies, a non-invasive diagnosis was proposed. In this study, we discuss the role of CMR in cardiac amyloidosis, focusing on the two most common subtypes (AL and ATTR), waiting for evidence-based guidelines to be published.
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BACKGROUND: The aim of this multicenter study was to evaluate the prevalence and features of dual left anterior descending artery (LAD) subtypes using coronary CT angiography (CCTA). METHODS: A retrospective multicenter analysis of 2083 CCTA from December 2020 to November 2022 was conducted to search for the presence and morphological features of dual LAD. The two classifications used were the updated classification of Spindola-Franco and the Jariwala classification. Statistical tests were conducted to evaluate the prevalence of dual LADs among sexes and its association with angina in patients without significant coronary stenoses and/or associated cardiac anomalies. RESULTS: Dual LAD was observed in 124 (5.96%) patients analyzed. According to the Spindola-Franco revisited classification, type I dual LAD was the most common (71/124, 57.26%). According to the Jariwala classification, all cases were group I. In the general population, there was a higher prevalence of dual LAD among females (7.3% females vs. 5.1% males; p value: 0.04). No statistically significant difference was found in the prevalence of angina in the dual LAD population compared to the no dual LAD population (2.1% vs. 1.5%; p value: 0.10). CONCLUSIONS: The acknowledgment and reporting of LAD duplication is helpful for an optimal management of coronary patients with this condition. Dual LAD was more frequent in the female population, mainly not related with angina. Myocardial bridge was more frequent in the dual LAD population than in the no dual LAD population.
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Background: The school gives access to children, regardless of age, ethnicity, gender and socio-economic class and can be identified as the key environment in which to promote children's physical activity (PA). The guidelines of the European Union recommend accumulating at least 10-min bouts of PA to reach the daily 60 min. Active breaks (ABs) led by teachers inside the classroom represent a good strategy to promote PA. The aim of this pilot and feasibility study was to evaluate the feasibility and effectiveness in terms of PA level of an AB programme in children aged 8-9 years attending primary school. Methods: A pre-post quasi-experimental pilot and feasibility study was performed in two primary school classes, one of which was assigned to a 14-week AB intervention (AB group) and the other to the control group (CG). At baseline and at follow-up, children were monitored for sedentary and motor activity during an entire week using ActiGraph Accelerometer (ActiLife6 wGT3X-BT). The satisfaction of children and teachers was assessed by self-administered questionnaires. Results: In the pre-post comparison, AB group (n = 16) showed a reduction in the minutes spent in weekly sedentary activity (-168.7 min, p > 0.05), an increase in the number of step counts (+14,026.9, p < 0.05) and in time spent in moderate to vigorous PA (MVPA): weekly MVPA: +64.4 min, daily MVPA: +8.05 min, percentage of MVPA: +0.70%. On the contrary, CG showed a worsening in all variables. ANCOVA analysis, after adjusting for baseline values, showed significant differences between the AB group and CG for time spent in MVPA, percentage of MVPA and step counts. The satisfaction of children and teachers was good. Teachers were able to adapt the AB protocol to the needs of the school curriculum, thus confirming the feasibility of the AB programme. Conclusions: This pilot and feasibility study showed the feasibility and effectiveness of the AB protocol and represented the basis for a future controlled trial.
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Exercício Físico/fisiologia , Exercício Físico/psicologia , Serviços de Saúde Escolar , Comportamento Sedentário , Actigrafia , Criança , Currículo , Estudos de Viabilidade , Feminino , Humanos , Itália , Masculino , Equivalente Metabólico/fisiologia , Projetos Piloto , Instituições AcadêmicasRESUMO
BACKGROUND: Environmental cleaning practice plays an important role in reducing microbial contamination in hospital surfaces and contributes to prevent Healthcare Associated Infections. Adenosine Triphosphate (ATP) bioluminescence assay is a commonly used method for assessing environmental cleanliness on healthcare surfaces. This study tested the feasibility of using ATP-bioluminescence assay for evaluating the efficiency of cleaning procedures in the operating theatre settings, comparing the ATP-bioluminescence test with the traditional culture method. METHODS: The surfaces of 10 operating rooms of two public hospitals (140 samples in total) were examined "at rest", in two moments of the same daily session: before the first scheduled operation (Pre), and before the second, after a clean environment was re-established (Post). Surface contamination was assessed using the cultural method to detect Total Viable Counts (TVC36°C) and ATP-bioluminescence assay (RLU). RESULTS: The examined surfaces presented very low TVCs (geometric means: 1.8 CFU/plate; IC95%: 1.6-2.0), always compliant with the relative reference standards. No statistical correlation was found between ATP values and TVCs. However, considering the results in terms of general evaluation of hygienic quality of surfaces, the two methods were consistent in identifying the most contaminated areas (Hospital A > Hospital B; Pre > Post; most contaminated surfaces: scialytic lamp). Furthermore, the ATP mean values showed a progressive increase from surfaces with TVC = 0 to surfaces with TVC > 15 CFU/plate. CONCLUSIONS: Although not an alternative to cultural methods, the ATP-bioluminescence-assay can be a useful tool to measure the efficiency of cleaning procedures also in environments with very low microbial counts. Each health facility should identify appropriate reference values, depending on the devices used and on the basis of the analysis of the data collected through spatial and temporal sampling series. By providing a rapid feedback, the ATP-assay helps to increase the awareness of operators and allows immediate action to be taken in critical situations.
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Trifosfato de Adenosina/análise , Descontaminação/normas , Higiene , Controle de Infecções/normas , Medições Luminescentes/métodos , Salas Cirúrgicas , Bioensaio , Contagem de Colônia Microbiana , Descontaminação/métodos , Estudos de Viabilidade , Hospitais/normas , Humanos , Controle de Infecções/métodos , Salas Cirúrgicas/normas , Prática Profissional/normasRESUMO
Urethral injuries due to penile prosthesis implant represent a rare complication of the intervention to position penile prosthesis, but unfortunately scientific literature about this is poor. This rare complication may occur during surgery and in the postoperative period, both early and late. It recognizes a variety of causes that may include anatomical or functional conditions, for example cavernosal fibrosis or outcomes of inflammations or previous urethral lesions and pathological sensibility due to diabetic neuropathy or other forms of neuropathy including those from spinal cord injury or myelopathy. This review evaluates the possible predisposing conditions, the clinical presentations, and the devices in the surgical procedures to use to minimize the risk of onset of this lesions and the measures to take if they occur.
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Complicações Intraoperatórias/etiologia , Implante Peniano/efeitos adversos , Prótese de Pênis/efeitos adversos , Complicações Pós-Operatórias/etiologia , Uretra/lesões , Complicações do Diabetes , Dilatação/efeitos adversos , Dilatação/instrumentação , Fístula/etiologia , Fístula/cirurgia , Fricção , Humanos , Complicações Intraoperatórias/prevenção & controle , Lacerações/etiologia , Masculino , Doenças do Pênis/etiologia , Doenças do Pênis/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Fatores de Risco , Estresse Mecânico , Uretra/cirurgia , Doenças Uretrais/etiologia , Doenças Uretrais/cirurgia , Derivação Urinária , Fístula Urinária/etiologia , Fístula Urinária/cirurgia , Ferimentos e Lesões/prevenção & controle , Ferimentos e Lesões/cirurgiaRESUMO
PURPOSE: During glutaminolysis, glutamine is catabolized to glutamate and incorporated into citric acid cycle and lipogenesis. Serum glutamate levels were measured in patients with primary prostate cancer or metastatic castrate-resistant prostate cancer (mCRPCa) to establish clinical relevance. The effect of glutamate deprivation or blockade by metabotropic glutamate receptor 1 (GRM1) antagonists was investigated on prostate cancer cells' growth, migration, and invasion to establish biologic relevance. EXPERIMENTAL DESIGN: Serum glutamate levels were measured in normal men (n = 60) and patients with primary prostate cancer (n = 197) or mCRPCa (n = 109). GRM1 expression in prostatic tissues was examined using immunohistochemistry (IHC). Cell growth, migration, and invasion were determined using cell cytotoxicity and modified Boyden chamber assays, respectively. Apoptosis was detected using immunoblotting against cleaved caspases, PARP, and γ-H2AX. RESULTS: Univariate and multivariate analyses showed significantly higher serum glutamate levels in Gleason score ≥ 8 than in the Gleason score ≤ 7 and in African Americans than in the Caucasian Americans. African Americans with mCRPCa had significantly higher serum glutamate levels than those with primary prostate cancer or benign prostate. However, in Caucasian Americans, serum glutamate levels were similar in normal research subjects and patients with mCRPC. IHC showed weak or no expression of GRM1 in luminal acinar epithelial cells of normal or hyperplastic glands but high expression in primary or metastatic prostate cancer tissues. Glutamate deprivation or blockade decreased prostate cancer cells' proliferation, migration, and invasion and led to apoptotic cell death. CONCLUSIONS: Glutamate expression is mechanistically associated with and may provide a biomarker of prostate cancer aggressiveness.
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Ácido Glutâmico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/patologia , Adulto , Negro ou Afro-Americano , Apoptose/efeitos dos fármacos , Estudos de Casos e Controles , Linhagem Celular Tumoral , Movimento Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Próstata/metabolismo , Neoplasias da Próstata/metabolismo , Receptores de Glutamato Metabotrópico/antagonistas & inibidores , Receptores de Glutamato Metabotrópico/metabolismo , Riluzol/farmacologia , População BrancaRESUMO
Hemangiopericytomas are rare soft-tissue neoplastic lesions that can arise in any part of the body. They are mesenchymal tumors that account for 3 to 5% of all soft-tissue sarcomas and 1% of all vascular tumors. They originate in extravascular cells (pericytes). Some 15 to 30% of all hemangiopericytomas occur in the head and neck; of these, approximately 5% occur in the sinonasal area. We describe our brief retrospective review of 7 histologically proven cases of sinonasal hemangiopericytoma, and we discuss the imaging characteristics and clinical and pathologic findings in these patients.
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Hemangiopericitoma/patologia , Neoplasias Nasais/patologia , Adulto , Idoso , Epistaxe/cirurgia , Feminino , Hemangiopericitoma/diagnóstico por imagem , Hemangiopericitoma/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias Nasais/diagnóstico por imagem , Neoplasias Nasais/cirurgia , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/cirurgia , Radiografia , Estudos RetrospectivosRESUMO
Excisional or incisional biopsies of melanoma are used to determine depth of tumor invasion and to plan subsequent treatment. Accurate determination of depth of melanoma invasion is critical for treatment decisions and prognosis. Incisional or punch biopsies can be perilous for histopathologic determination of invasion, and both over- and underestimation of invasion can occur when using incisional methods. Likewise, histologic factors can lead to over- and underestimation of invasion. Prognosis and treatment of melanoma are primarily determined by depth of tumor invasion. We discuss several scenarios that can lead to over- and underestimation of depth of invasion in incisional biopsy specimens. We therefore discourage incisional or punch biopsies of suspected melanoma and recommend that depth of invasion not be reported on these types of specimens.
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Biópsia por Agulha/métodos , Melanoma/patologia , Neoplasias Cutâneas/patologia , Erros de Diagnóstico , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Condrossarcoma/diagnóstico , Neoplasias Laríngeas/diagnóstico , Laringoscopia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha , Condrossarcoma/epidemiologia , Condrossarcoma/cirurgia , Estudos de Coortes , Feminino , Humanos , Imuno-Histoquímica , Incidência , Neoplasias Laríngeas/epidemiologia , Neoplasias Laríngeas/cirurgia , Laringectomia/métodos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Doenças Raras , Distribuição por Sexo , Taxa de Sobrevida , Tomografia Computadorizada por Raios XAssuntos
Calcinose/etiologia , Condromatose Sinovial/diagnóstico , Ombro/patologia , Adulto , Feminino , HumanosRESUMO
Peri-renal fat necrosis is rarely encountered, especially in the absence of previous surgery, trauma, or pancreatic disease. We report a patient being followed for chronic renal insufficiency by renal ultrasound in whom a renal mass was detected. Imaging studies were suggestive of renal cell carcinoma with extra-capsular extension. Histologic study confirmed renal cell carcinoma but the radiographic impression of tumor extension into surrounding adipose tissue was explained by peri-renal fat necrosis and fibrosis. To the best of our knowledge, this is the second reported case of peri-renal fat necrosis associated with renal cell carcinoma. We propose a possible mechanism for the association.
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Carcinoma de Células Renais/complicações , Necrose Gordurosa/etiologia , Neoplasias Renais/complicações , Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/cirurgia , Humanos , Rim/diagnóstico por imagem , Rim/patologia , Neoplasias Renais/diagnóstico , Neoplasias Renais/cirurgia , Masculino , Pessoa de Meia-Idade , UltrassonografiaRESUMO
Traditional methods to identify dimorphic fungi dictate that the mold be converted to the yeast phase at 35 to 37 degrees C. We present a time- and cost-saving method of confirming the identification of a dimorph by using special stains to demonstrate the yeast phase directly growing in the original clinical specimens.
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Fungos/classificação , Histoplasmose/diagnóstico , Candida/isolamento & purificação , Fungos/isolamento & purificação , Histoplasma/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
An unusual case of a cutaneous collision tumor comprised of a squamous cell carcinoma and an apocrine carcinoma occurring in the auricle of an 82-year-old man is presented. Microscopic study confirmed 2 distinct tumors: a squamous cell carcinoma arising in the epidermis and an adjacent apocrine carcinoma. We discuss the diagnostic criteria and review pertinent recent literature. To our knowledge, this is the first English language report of such a collision tumor.
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Glândulas Apócrinas , Carcinoma de Células Escamosas/patologia , Neoplasias da Orelha/patologia , Neoplasias Primárias Múltiplas/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Idoso , Carcinoma de Células Escamosas/cirurgia , Neoplasias da Orelha/cirurgia , Humanos , Masculino , Neoplasias Primárias Múltiplas/cirurgia , Neoplasias das Glândulas Sudoríparas/cirurgiaRESUMO
Workup of a patient with lung cancer involves adrenal imaging for evaluation of metastatic disease. When nodules are detected, biopsy is often attempted to differentiate a primary neoplasm from metastatic carcinoma or other lesions, such as granuloma. CT-guided biopsy of the deep seated adrenal glands is technically difficult and material is often scanty. We present a case and review histologic features enabling the diagnosis of adrenal cortical carcinoma.
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Neoplasias do Córtex Suprarrenal/secundário , Carcinoma Adenoescamoso/patologia , Neoplasias Pulmonares/patologia , Neoplasias do Córtex Suprarrenal/diagnóstico , Neoplasias do Córtex Suprarrenal/patologia , Idoso , Biópsia , Carcinoma Adenoescamoso/diagnóstico , Humanos , Neoplasias Pulmonares/diagnóstico , Masculino , Metástase NeoplásicaAssuntos
Osso Nasal/diagnóstico por imagem , Osso Nasal/patologia , Neoplasias de Tecido Vascular/diagnóstico por imagem , Neoplasias de Tecido Vascular/patologia , Neoplasias Nasais/diagnóstico por imagem , Neoplasias Nasais/patologia , Idoso , Humanos , Masculino , Osso Nasal/cirurgia , Neoplasias de Tecido Vascular/cirurgia , Neoplasias Nasais/cirurgia , RadiografiaRESUMO
Prostatic epithelial polyps, also known as adenomatous polyps or papillary adenomas with prostatic type epithelium, are uncommon lesions. These lesions typically involve the adult male urethra, trigone, or bladder dome. Diagnosis is usually made by biopsy. Presence of clusters of benign columnar cells in urine cytologic material can suggest the presence of such polyps and must be included in the differential diagnosis.